SAD or seasonal affective disorder is a common disease many are not aware of. Pay attention to these lesser-known winter blues symptoms.
They weren’t the terms on which Rose wanted to leave her job. The Londoner just hadn’t felt “right” all winter. Before long, she found herself not leaving the house for days, just feeling sorry for herself.
“I was only 25, but felt tired all the time. My body would just sink. Everything would feel heavy. I’d stay in bed waiting to feel better, but wouldn’t,” says the now 33-year-old London transplant from Zimbabwe.
Rose dreaded going to work. Her attendance plummeted. Even when she made it to the office, she felt “so keyed up” she couldn’t cope with her workload.
Ultimately, Rose had to give up her full-time job as a nurse. Now, her work is more seasonal, allowing her quieter winters. “I bottled it up far too long,” she says. “I’d get stuck and not know if the next day I’d get better … or worse. I couldn’t trust myself. I felt petrified that I was losing control.” She had tried to “push on and act normal,” but to no avail.
What Is SAD?
In winter, it’s common to hear jokes about being stuck in cave mode or the hibernation zone or coming down with cabin fever, due to that “winter funk,” or the winter blahs, doldrums or blues. But severe SAD should not be taken lightly — it can lead to dangerously dark thoughts of death and suicide.
SAD (seasonal affective disorder) is a type of depression that occurs the same time each year, according to Mayo Clinic. For most people it strikes anywhere from late autumn through winter when the days are shorter, darker and colder (though in some it can occur in spring and summer).
“About 6 percent of Americans may have the winter depression clinically referred to as SAD,” says Julia Samton, MD, who treats a range of mood disorders at Manhattan Neuropsychiatric, “and an additional 10 to 20 percent have mild SAD. It is four times more common in women than men.”
Winter SAD Signs
Recently, I remarked to a friend, “Man, the winter just makes me so hungry, all the time! Wonder why that is.”
If you’re anything like me, every winter you find yourself munching all the frickin’ time — and not the leafy kale salads and salmon fillets I usually desire. Nope, I’m talkin’ hearty chili and beef stew with tender chunks of juicy meat, and potatoes (mashed, grilled, baked, you name it) — that’s what I crave. Last week, I made spaghetti (whole-wheat, to be sure) bolognese for dinner, with a green salad for good measure … six nights in a row. When I went to the supermarket, all I could imagine was a piping-hot plate of pasta and meat sauce.
It seemed to make sense. It’s bitter cold out. We all hibernate. And it seemed that putting more meat on the bones would go far in cushioning against the arctic chill, helping one to stay warm and toasty.
Well, turns out there’s a little more to it.
Craving carbs? Increased appetite? Imagine my surprise when I recently learned these are lesser-known signs of SAD.
“Along with oversleeping, feeling energy-zapped, apathetic, unmotivated, common SAD symptoms, hyperphagia (increased appetite and overeating) is also a sign,” says Dr. Samtom.
Mild SAD may just feel like the winter blahs, she says. “You’re sleepy, more sensitive to criticism or generally dissatisfied with life.”
Severe SAD, though, has added symptoms including those of major depressive disorder, she says, including depressed mood, diminished interest in life, feelings of worthlessness, low self-esteem, excessive or inappropriate guilt, indecisiveness, poor concentration, and thoughts of death and suicide. With severe SAD, symptoms are present at least two weeks, says Dr. Samton, and moods negatively impact social, educational and even work functioning.
What Causes Old Man SAD
The exact cause is unknown, but SAD is likely linked to age (Samton says it’s less common before 20, and risk decreases with age), genetic makeup and your body’s natural chemical makeup, explains Mayo Clinic.
SAD’s grip, though, has much to do with sunlight, or loss of it. Less bright light creates a trifecta effect: biological clock malfunction, melatonin dip and seratonin slump.
Increased darkness can throw the body’s internal circadian clock outta whack, making it harder for us to know when to sleep and when to rise, thereby prompting depressive feelings. Reduced sunlight can also lead to a dip in seratonin, a brain chemical tied to mood, which may inhibit pain pathways in the central nervous system. The balance of the hormone melatonin, which affects sleep patterns and mood, can also be thrown into a tailspin with seasonal change.
Who’s at Risk
At increased risk: women, people living far north (hello, New Yorkers) or south of the equator, those with blood relatives diagnosed with depression and/or having been diagnosed with depression (symptoms may worsen in winter).
Signs of Winter SAD
Rose described feeling excessively teary and being on a draining insomnia cycle — tired but up late because she couldn’t sleep. Unable to “snap to,” she’d get frustrated and angry.
* Feeling anxious, sad, empty, pessimistic, worthless, guilty, hopeless
* Low energy, fatigue
* Arms and legs that feel lead-heavy
* Weight changes
* Increased irritability, restlessness
* Oversleeping or trouble sleeping
* Difficulty focusing, remembering details, concentrating
* Lost interest in activities you typically enjoy
* Social withdrawal (cancelling appointments and social engagements)
How Is SAD Treated
“Some people take medication with good results, but I refused to take medication, which was a personal choice,” says Rose. “I wanted to try natural alternatives first. Luckily that worked for me … but it wasn’t easy.”
Under her doctor’s recommendation, Rose kept a mood journal. Over time, she and her doctor studied the timeline to identify “relapse indicators” and patterns.
“It is well documented that light can be beneficial in the treatment of SAD,” says Dr. Samton, pointing to studies suggesting that light can increase the concentration of the neurotransmitter serotonin. In one study of pain and stress levels after spine surgery, patients assigned to sunny hospital rooms had less stress than those in shady rooms at discharge.
Just flipping on lights won’t cut it. Light boxes should be specifically labeled for SAD treatment, says Dr. Samton. They should filter out most UV light, and use fluorescent or incandescent light. Most studies have shown positive effects on one’s mood with a 10,000 lux light used for 30 minutes upon waking, placed at least two feet away, says Dr. Samton. (Available on Amazon.)
Regular exercise, cognitive behavioral therapy (CBT) and engaging in social activities may also help, she says.
Think activity and movement, says Michael Mantell, PhD, senior fitness consultant for behavioral sciences at ACE. Try bundling up and walking across the bridge to work, taking the stairs, walking to dinner and resisting the shortcuts, he suggests.
“Cold weather is never an excuse not to exercise. Move it indoors if you need to. Try portable, versatile workout equipment and pop in a challenging DVD or try a free YouTube workout routine. Look for home or office workouts including push-ups, chair dips and lunges.”
Or try something different, such as a heated pool at the local community center, he recommends. Or try skiing, snowboarding, snowshoeing or a winter hike.
Rose also found getting on a regular routine helped. “You have to stick with it,” she says, “especially when it gets hard. It’s easier if you have people who will push you when you can’t do it. But if you don’t, you have to make a conscious choice to join a club or to take a class where you’ll be missed if you don’t turn up.”
Rose joined a gym, signed up for morning classes. Even walking the few miles to get there made her feel better. “It’s so much harder to make those classes in winter, but if I can make it 80 percent of the time, I know I’m doing OK.” The gym gave her a reason to get up, she says. And she’s found new work running a site called ThePowerofWoman.net.
Dr. Samton explains that structure and routine can be reassuring during difficult periods. And that regulating sleep and wake cycles can also help to synchronize the body’s circadian rhythm and mitigate sleep disturbances.
Tell Your Friends
Rose is grateful for her supportive friends who “just kind of work around” her when she has “off days.” She admits to having to force herself to interact in winter. “But I do it,” she says, “so I don’t fall out of practice being around people.”
Her advice to those who have loved ones with SAD: “Know that it’s not personal when they start to withdraw. Just try and be there for them until they feel better.” She admits that her pals do have to drag her out of the house when she’s been out of the loop too long. And when they do, she is very glad.